Cholesteatoma Causes Symptoms and Treatments


Cholesteatoma is a common chronic ear
disease that we see in the ENT practice but most of the time with patients that
have ear infections, a small percentage of them develop into cholesteatoma.
Cholesteatoma is a area of trapped skin that gets built up behind the ear. It
will cause local destruction of the structures within the ear. Cholesteatoma
develops because there’s some eustachian tube dysfunction so the tube
that ventilates the ear, lets air stay behind there isn’t working adequately
and so we get a negative pressure and the eardrum will get suctioned in and
it has a little pocket that forms. Normally the eardrum will slough off
skin and so that skin gets caught or stuck in that pocket and then it
continues to grow slowly over time and then can develop further destruction
into the ear and progress further. Other times that it can develop is if someone
has a hole in the eardrum. Sometimes the skin from the eardrum surface can travel
underneath and cause that as well. It usually looks like a pearl and so bright
white and sometimes forms like a nice capsule around it. Sometimes
cholesteatoma can go on for a while before patients are really noticing some
symptoms. Usually the symptoms can include hearing loss or they can have
drainage from the ear usually the drainage can be chronic and it will
persist even after treating an infection. Cholesteatoma can cause a lot of damage
in the ear so it can destroy those the little bones of hearing and so lead to
hearing loss. It can also extend over one of the nerves that travels through
the ear that controls the muscle of your face, so can lead to a facial weakness.
In more advanced cases it can eat into the inner ear and cause dizziness
or more of a sensory neural or nerve hearing loss as well as lead to brain
infection. Most cholesteatoma is treated with surgery so in some cases if there’s
an infection with the cholesteatoma we treat the infection first but antibiotic
for other treatments is going to make the skin cyst go away, so we have to
surgically remove that.

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